RU2498367C2 - Myopia control means - Google Patents

Abstract

FIELD: physics.

SUBSTANCE: each lens of the set, kit or stock has a central optical axis and a central optical zone having a corrective refractive power from weak refraction to -6.0D, and a peripheral optical zone surrounding said central zone. The peripheral zone is characterised by an incident angle with respect to the optical axis of about 30 degrees; the peripheral zone of each lens has a positive refractive power relative to the refractive power of the central zone of that lens to thereby provide myopic peripheral defocus not greater than 3.5D. Also the lenses of the set, kit or stock are arranged in an orderly manner such that a doctor is able to select a lens with corrective power to provide or procure a lens to inhibit progression of myopia without needing to first measure peripheral refractive error in the eye and to order a lens with customised peripheral power.

EFFECT: design of a set, kit or stock of lenses which are efficient during use and which do not require a doctor to measure peripheral refractive error of the eyes of a myopic patient.

36 cl, 27 dwg

Description

Technical field

The present invention relates to agents that slow down the development of myopia or improve the situation associated with it, in particular in young people, and includes both methods and devices. These methods include procedures for the appointment, selection, fitting and dispensing of contact and spectacle lenses. The device includes funds, kits or sets of such lenses, including accessories or the actual lens components.

In the present description, contact and spectacle lenses that are suitable or intended to correct refractive errors in the central zone and slow the development (increase in degree) of myopia over time are referred to as “anti-myopia” lenses.

State of the art

Myopia (myopia) is a visual impairment in which the accommodation of the lens of the eye allows focusing on the retina (in its central region) only closely located objects, while the image of distant objects focuses in front of the retina. This means that the focusing ability of the eye "for distance" is too great compared with its accommodative ability. This situation is corrected by using lenses with negative refraction in the central zone, providing accommodation of the lens with focusing of images of both close and far located objects in the fossa in the central part of the retina. Hypermetropia (farsightedness) is a visual impairment in which the image of distant rather than close objects is clearly focused, and correction is carried out using lenses with positive refraction.

Progressive myopia, which is commonly believed to be caused by a gradual increase in the length of the eye, but not in its optical power, can cause serious complications leading to visual impairment despite the use of increasingly powerful corrective lenses. In some Asian countries, it is reported that more than 80% of young people aged 17 suffer from myopia, and in many it is. probably progressing or starting to progress.

There is a general opinion that the normal development of the eye during the growth of the body, called emmetropization, is regulated by a feedback mechanism that controls the length of the eye and provides central focusing due to accommodation both at long and near distances (this normal state is called emmetropia). This suggests that with progressive myopia, the work of this feedback mechanism is disrupted, as a result of which the eye continues to lengthen excessively even when using good corrective lenses. The nature of this feedback mechanism is devoted to many conflicting theories, in connection with which many different treatment methods for progressive myopia have been proposed.

It is assumed, for example, that in the feedback mechanism that controls the growth of the eye, disturbances somehow arise due to the insufficient accommodative effort of the eye during work associated with excessive tension in the near vision. It is believed that this insufficiency serves as clear evidence of the delay in accommodation (inaccurate and insufficient accommodation) at close range, which results in defocusing, which, in turn, stimulates the unwanted axial lengthening of the eye. Therefore, bifocal and varifocal (progressive) lenses were used in the glasses in order to relieve the stress of accommodation and defocus in the hope that this would eliminate the inducing cause of lengthening. However, clinical studies have shown poor performance compared to standard refractive correction using negative optical power lenses.

US Pat. No. 6,754,499 to Aller reports on the results of the administration of commercially available concentric bifocal contact lenses for the treatment of progressive myopia in combination with near esophoria. Contact lenses with central zones were used to correct both far and near. These lenses, with correction zones both far and near, are located within the normal pupil diameter (the “optical zone" of the lens), have the disadvantage that in all cases they form two central images on the retina, as a result of which the image quality is always reduced. In addition, the success of such treatment methods is apparently limited and inconsistent.

In US Pat. No. 6,045,578 to Collins et al., It is assumed that emmetropization is controlled by the degree and direction of the spherical aberration that exists in the region of the central fossa of the retina. It has been suggested that young myopes have a higher level of negative spherical aberration in the central region, which contributes to disproportionate eye growth, and that the use of therapeutic lenses to introduce positive spherical aberration into the central region will slow down axial excess growth and, therefore, the development of myopia. We do not have information about publications that would report on any significant comparative trial using lenses defended by Collins et al. For the treatment of progressive myopia. Nevertheless, we note that additional spherical aberration further worsens the quality of central vision for both near and far, and, according to the above, by definition is undesirable.

In WO200604440A2, Phillips et al., It has been suggested that simple defocusing in the central fossa of the retina for long and short vision slows down excessive eye growth. In accordance with this assumption, the use of bifocal contact lenses, which synchronously provide in the central part of the retina (a) a clear image both for the distance and near, and (b) myopic defocusing for the distance and near, is investigated. And in this case, we note the deterioration of central vision, as well as our lack of information about publications that would report on any significant comparative tests confirming the effectiveness of this approach.

In contrast to the patents mentioned above, US Pat. No. 7,025,460 by Smith et al. Describes the results of animal studies that show that the presence of a feedback mechanism stimulating emmetropization is associated with the nature of peripheral rather than central vision (The results of these studies and experiments were published in prestigious scientific journals, where they were evaluated and received approval from wide circles of the scientific community). So, Smith et al. Report that taking measures against off-axis focusing by controlling the curvature of the field in order to gradually shift the image in front of the peripheral region of the retina with an increase in the peripheral angle is the basis for a method of reducing, slowing down or regulating the development of myopia. The lenses providing such control of the peripheral image are accordingly called “anti-myopia” because they slow down the development of myopia and also correct the refractive error in the central region. Smith et al. Noted that the problem of hyperopia, or hyperopia (near vision impairment caused by insufficient eye length) could be solved by controlling the curvature of the field to gradually shift the image behind the peripheral region of the retina.

International patent application WO / 2007/146673 by Holden et al. Describes anti-myopia lenses with two zones whose design and manufacturing processes are simpler than lenses where the peripheral zone curvature is controlled by Smith etc. In such lenses, the central zone providing the refractive correction necessary for good central vision approximately corresponds to the diameter of the pupil and is surrounded by a single-focus therapeutic peripheral zone having refractive power. to move at least part of the peripheral image in front of the retina. Despite the fact that the results of the work of Smith and others are confirmed and agree with Holden and others that anti-myopia lenses with two zones are easier to design and manufacture, the implementation of the ideas of Smith and Holden's inventions in practice is not so simple, because this requires tools, training, and peripheral refraction measuring instruments that are not widely available, especially in poor countries where progressive myopia is an acute problem. Correct prescribing of anti-myopia lenses with a peripheral zone matched to the patient’s eyes requires, for example, (I) a peripheral zone refractometer capable of reliably determining the peripheral focus, (II) trained personnel of the appropriate qualifications who can use such refractometers and accurately indicate characteristics corrective lenses required by a particular patient, as well as (III) the availability of equipment capable of producing custom-made special lenses with a prescribed optical distribution th power in the central and peripheral zones. The associated costs can make anti-myopia lenses unattainable for most of those who need it, despite the fact that they are simpler in design and technical conditions than Smith's progressive anti-myopia lenses and others.

Here it is necessary to dwell on three terminological points: how the degree of development of myopia is indicated, the difference between ordinary bifocal and anti-myopia lenses and the use of absolute and relative terms to indicate the optical power of the peripheral zone of the lens.

Firstly, it is common practice to name the patient, for example, “myopus minus 3D,” which means that the patient needs or wears corrective lenses at -3 diopters (“D”). This can create confusion because the patient has a refractive error + 3D and could be called, following the same logic, "miop + 3D". Due to the fact that traditional terminology is rooted in practice, it is used in the present description, but with special instructions on whether it is a question of refractive error of the eye or the optical power of a corrective lens.

Secondly, an ordinary bifocal lens has two central optical zones with different refractive powers, one of which provides good central far vision, and the other provides good central near vision. In spectacle bifocal lenses, the near vision zone is located in the lower part of the lens, and the far vision zone is in the central and / or upper parts. This ensures automatic selection of the desired area and image with normal eye movement, so that it forms one image. Since conventional bifocal contact lenses are located on the cornea and move with the eye, both of their zones (far and near vision) are located in the central part of the lens, approximately corresponding to the normal diameter of the pupil. Consequently, in the area of the central fossa of the retina, there are always simultaneously correlated images of distant and close objects, which allows the brain to distinguish one or the other, however, the quality of each image inevitably deteriorates due to the presence of another image. Anti-myopia lenses are inherently (or even preferably) not bifocal in the sense that there is no problem for them to provide good near or far central vision using different central optical zones. Instead, anti-myopia lenses usually have a central refractive zone that provides correction of myopic refractive error in the center and good central vision, as well as a peripheral “therapeutic” refractive zone outside the central zone that can slow down continued eye growth. However, anti-myopia lenses can also be bifocal: in this case, in addition to the therapeutic peripheral zone, they have two central zones like conventional bifocal lenses.

Thirdly, the difference between the refractive forces of the central and peripheral zones of the anti-myopia lens is often referred to as “peripheral defocusing”, since it is common practice to describe the lenses based on the magnitude of the main refractive correction carried out in the entire optical zone, taking into account another refractive power at the periphery, which represents a modified basic correction. Thus, if the peripheral refractive power is less negative than the central one, then it is said that the corrective lens has peripheral "myopic defocusing", and if the peripheral refractive power is more negative than the central one, then they say that the lens has "hyperopic defocusing" by the periphery. This is confusing if changing the optical power in the peripheral zone improves focusing in this zone. On the other hand, since the peripheral defocusing of many anti-myopia lenses is increased in order to ensure that the peripheral image is in front of the retina, these lenses can cause a focus error, or image blur, in the peripheral region of the retina. In the present description, the term "peripheral defocusing" is conventionally used to refer to the relative difference between the refractive forces in the peripheral and central zones of the anti-myopia lens, and "optical power of the peripheral zone" means the absolute refractive power in the peripheral part of the optical zone of the lens. However, it is clear that the values of "peripheral defocusing" and "optical power of the peripheral zone" are essentially equivalent, since one can easily be obtained from the other with a known value of the optical power in the central zone of the lens. It should also be noted that peripheral defocusing can be different for different radial segments of the lens, if the optical power of the peripheral and / or central zone does not remain constant with a change in radius. Finally, the peripheral defocusing experienced by a patient wearing anti-myopia contact or spectacle lenses is referred to herein as “blurring” or “peripheral blurring”.

Disclosure of invention

While appreciating the scientific contribution of Smith et al. Published in scientific and patent literature, and recognizing the practical benefits of dual-zone anti-myopia lenses as proposed by Holden et al, the cost of anti-myopia lenses and therapies offered by Smith / Holden is, however, of concern. , for myopes, in particular, for young myopes in developing countries, where progressive myopia is a common and disruptive factor. Since the data of the authors' research works show that the optimal area of the peripheral image to be affected by an anti-myopia lens with two zones is that created by a peripheral beam incident at an angle of about 30 degrees, a wide examination of the eyes of young myopes in Australia and China was conducted during which the refractive error was measured at this angle in the central and peripheral zones in the presence of their usual corrective lenses and without them. Peripheral error was measured at an angle of approximately 30 degrees to the visual axis in the temporal, nasal and upper quadrants of the retina. According to estimates from other studies related to progressive myopia, it has been concluded that the sample of young myopes covered by the study is generally representative of a degree of myopia of -0.25D to -6D for the whole world. People belonging to this cohort or group can be called “normal myopes” to distinguish them from people with high degree myopia or with pathological myopia, in which this degree is significantly worse than -6D. In short, the authors of the present invention believe that their strategies for slowing progressive myopia, presented in the present description, in most cases can be applied to normal myopes. These studies are summarized in figure 3-11, but in the scientific literature it will be possible to find publications containing more technical details.

Summarizing the results of the study of the authors, the following can be noted:

1. An amazing result, which is in clear contradiction with the ideas of Smith et al.: All naked eyes with significant myopia (refractive error in the central region of more than + 1.75 D) did not have hyperopia in the peripheral region. Weak hyperopia (less than -1.0 D) in the peripheral region (with a tendency to localization in the temporal quadrant of the eye) was present only in eyes with a refractive error in the central region of less than + 1.75 D.

2. The degree of refractive error in the peripheral region with a beam falling at an angle of 30 degrees for the naked eye is generally directly proportional to the degree of refractive error in the central region, and this proportionality is more accurate in the nasal meridian. For unaided eyes with a refractive error in the central region ranging from approximately + 1.75D to approximately + 3.75D, this degree of refractive error in the peripheral region increases approximately proportionally from zero to approximately + 2D, and for errors in the central region, increasing in the range from approximately + 4.0D to approximately + 6.0D, the error in the peripheral region increases from approximately + 2.0D to a value slightly higher than + 4.0D, again with significant preservation of proportionality.

3. Thus, instead of the fact that the naked eye with the highest degree of myopia had the greatest hyperopia in the peripheral region, they had the largest myopia in this region; according to Smith et al., this means that these eyes have the greatest growth retardation.

The obvious contradiction between the results of our research and the ideas of Smith et al. Is easily resolved if general refractive errors are measured in the "armed eyes", i.e. when the patient being examined puts on their everyday contact or eyeglass lenses. In this case, it is found that almost all armed myopic eyes have hyperopia in the peripheral region, and this hyperopia is the greater, the greater the refractive error in the central region. In other words, giving the optical power of a conventional lens some negative value sufficient to place the focus formed by the central part of the lens on the retina, in the case of the armed eye, will shift the focus formed by the peripheral part of the lens back to the position behind the retina, resulting in the peripheral Hyperopia occurs in the area and conditions are created for further eye growth. Paradoxical as it may seem, for myopes from -4D to -6D (that is, for the upper limit of the range that defines the “normal” group), any therapeutic benefits of their really existing (with naked eyes) peripheral myopia are absorbed by peripheral hyperopia brought by corrective traditional design lenses. In short, the results of our study convincingly confirm the hypothesis of Smith et al. Studies of the authors show that the vast majority of myopes will use contact lenses with 3.0D myopic peripheral defocusing at a beam incident at an angle of 30 degrees, and that peripheral defocusing lenses will be acceptable for many above 3,5D. This information, combined with the results of the extensive studies mentioned above, shows the presence of a very high statistical probability (about 95%) that contact lenses myopi with a degree of -6D and better can be selected from existing stocks of finished lenses that provide error correction in central region and possess a predetermined myopic peripheral defocusing sufficient to slow the development of myopia, but do not introduce unacceptable peripheral blur. Since the situation with myopes wearing glasses is - within tolerance and to a large extent - the same as with those who wear contact lenses, their tolerance to peripheral blur can be somewhat reduced due to "buoyancy", that is, peripheral blurring that changes with eye movement. However, buoyancy can generally be reduced by adjusting the base curve of the eyeglass lenses.

Therefore, the manufacture, use and dispensing of finished sets, kits or funds of anti-myopia lenses with predetermined correction values and the optical power of the peripheral zone constitute one aspect of the present invention. Another aspect is pre-packaged or manufactured kits, kits or funds in which the lenses are arranged or ordered according to the amount of correction and / or degree, or level, peripheral defocusing in order to facilitate the use and understanding of doctors and patients. For example, understanding can be facilitated by the use of only a few degrees of optical power of the peripheral zone (so that many lenses within a certain range of optical power of the central zone have the same optical power of the peripheral zone). In an additional or alternative embodiment, a set of several anti-myopia lenses that have the same optical correction power in the central zone, but different values of the optical power of the peripheral zone, allows the doctor to choose the value of the optical power of the peripheral zone, defocusing, or therapeutic effect based on the patient’s estimated predisposition to progressive myopia. Therefore, another aspect of the invention relates to methods for prescribing and / or pre-fitting anti-myopia lenses in accordance with the present invention.

In the case of contact lenses, it is preferable that the optical correction power in the central zone of the anti-myopia lenses from the kit, kit or stock increase with an increment of about -0.25D, which gives about 20 increments in the range up to -5D or about 24 increments in the range to -6D, but another increment step can be used. Preparing a population of more lenses with a smaller increment is possible but not cost effective, while fewer lenses with a larger increment (for example, -0.33D or even -0.50D) can save money, but will be lower optimal for the patient. It is clear that many copies or batches of each lens can be included in a kit or set of contact lenses in order to create a fund of identical lenses, allowing many identical prescriptions or adjustments to be made without replenishing the kit. Contact lenses are usually packaged in hygienic sachets, which indicate the optical correction power in the central zone, the optical power or defocusing in the peripheral zone and the degree of exposure (the magnitude of peripheral defocusing). It is also clear that not every contact lens kit, kit or stock formed in accordance with the present invention should have a complete range of lenses, for example from -0.25D to -6.0D, since a smaller kit may be more suitable for a practitioner who prefers to work only with certain categories of patients.

Foundations, kits or sets of eyeglass lenses may have distinctive features that are completely different from those indicated above for contact lenses, since they may contain only a few false (for example, mounted or glued) lenses mounted on glasses used by the patient. Such false lenses may have non-refracting (flat) central zones, and their proposal includes only a few levels of peripheral myopic defocusing or optical power, the choice of which is carried out in accordance with the desired therapeutic effect and / or patient tolerance to buoyancy. The term "refractory" ("lens plan", from the English - piano lens) here means the negligible contribution of refractive power made by these lenses / zones to the total distribution of the optical power of this combination of lenses. These false lenses with non-refracting central zones can be transparent biconvex disks in which the central part has negligible optical power, or they can be annular and have a hole in the central zone instead of any material. The first of these options is more preferable, since the influence of the physical edges of the hole is excluded, and the transition in the distribution of the optical power between the non-refracting center and the selected periphery can be made smooth. In addition, if the patch lens is not rigid (as in the case of nozzle lenses), but flexible (detachable and sticky plate lenses), then working with thin sticky discs is much easier than with thin rings. Another aspect of the present invention relates to false eyeglass lenses of the specified type, which are used to convert standard eyeglass lenses to anti-myopia.

Alternatively, kits, kits or funds of prefabricated and finally processed anti-myopia eyeglass lenses with optical power increments in the central zone and degrees and / or levels in the peripheral zone can be provided or used, providing the advantage of more accurate selection, despite the additional costs. Further, due to the buoyancy problem in some spectacle lenses, the total number and range of finished lenses may be less than in the case of contact lenses. Precision alignment of the optical power in the peripheral and central zones, provided by the availability of a complete set of ready-made spectacle lenses for selection, can be of particular importance for large clinics that have equipment for the final processing of basic lenses in the clinic itself. It is also clear that both the contact and spectacle lenses discussed in this description can be rotationally symmetric or rotationally asymmetric, that is, some of them can have substantially the same peripheral defocus in all quadrants, while other defocus levels in different quadrants may differ from each other.

Thus, the doctor’s work on measuring refraction in the peripheral region of the eye, calculating the correction required to achieve the desired therapeutic effect, identifying and obtaining lenses for a particular patient disappears if such a set of ready-made anti-myopia lenses is available. Although it is preferable for a doctor to have a set of anti-myopia lenses for pre-fitting and / or dispensing to the patient, it may be sufficient for him to simply determine the refractive error in the central region and the design or style of the lenses, and then order the anti-myopia lenses of the appropriate shape and with the appropriate degree of correction in the central zone from stock or kit available from the manufacturer or wholesale supplier.

Another aspect of the present invention relates to a kit, kit or stock of ready-made anti-myopia lenses for a patient with myopia, where each lens has a central optical axis, a central optical zone with a refractive correction value of less than about -6.0 D, and a peripheral optical zone located outside the central zone , with an angle of incidence of about 30 degrees and myopic defocusing not exceeding approximately 3.5D. These lenses can be rotationally symmetric and have the same peripheral defocusing in all quadrants, or they can be rotationally asymmetric with peripheral defocusing only in the selected quadrants, with the nasal and temporal quadrants of the lenses being preferred. The lenses included in the kit are arranged in order, so the doctor can choose a lens with an appropriate correction value in the central zone, which slows down the development of myopia, without measuring the refractive error in the peripheral zone and making an individual order of the lens with the required optical power of the peripheral zone (i.e. without writing a prescription for lenses with the optical power of the peripheral zone required by this patient).

Another aspect of the present invention relates to anti-myopia lenses formed from a base lens with a central optical correction zone corresponding to at least the normal diameter of the pupil, and a therapeutic lens attached to the base and having a refracting central zone. This therapeutic lens has a ring-shaped peripheral zone surrounding a central refractory zone of sufficient size to provide incidence angles of about 30 degrees, and its refractive power is more positive than that of the central correction zone of the base lens.

Another aspect of the present invention relates to a method for dispensing or selecting anti-myopia lenses for a patient with myopia, comprising the following procedures: measuring refractive error in the central region of the myopic eye, assessing a patient's predisposition to progressive myopia based on his medical history, selecting the first lens from a kit, kit, or stock of finished lenses having (I) the amount of refractive correction in the central zone, which is in the best agreement with the measured refractive error, and (II) the value peripheral myopic defocusing, which is best consistent with the patient’s estimated predisposition to progressive myopia, dressing the first lens on the eye to determine the acceptability of peripheral blur and, if successful, dispensing the first lens or issuing a prescription for this lens. If the magnitude of myopic defocusing is unacceptable, a second test lens with the same amount of refractive correction in the central zone, but with a smaller amount of peripheral myopic defocusing, is selected from the lens kit, kit or stock.

In another embodiment, this method can use a kit, kit or stock, including several lenses with the same amount of refractive correction in the central zone, but with different values of peripheral myopic defocusing, the method includes the following procedures: measuring refractive error in the central areas of the myopic eye, studying the patient’s medical history to assess his predisposition to progressive myopia, and dispensing, prescribing, or selecting a lens having (I) refractive power in prices the central zone, providing correction of the measured refractive error, and (II) the magnitude of peripheral myopic defocusing, corresponding to the patient's estimated predisposition to progressive myopia.

Another aspect of the present invention relates to a method for manufacturing spectacle anti-myopia lenses, which includes the following procedures: measuring refractive error in the central region of the eye, assessing a patient’s predisposition to progressive myopia based on his medical history, prescribing and fitting a standard spectacle lens to the eye that provides error correction, selection of an auxiliary lens with a non-refracting central zone surrounded by a peripheral zone with positive optical power corresponding to the estimated the patient’s susceptibility to progressive myopia, and coaxially attaching the auxiliary lens to the standard lens so that a combination of standard and auxiliary lenses provides peripheral defocusing to slow the development of eye myopia.

Another aspect of the present invention relates to an ophthalmic device, for example, an ophthalmic lens, such as a contact lens, designed to slow the development of myopia of the eye and containing a central spherical part with a given optical power, determined by the degree of myopia, and a peripheral part with a given distribution of optical power, which provides relative refraction in the peripheral region of the eye and the distribution of optical power in which determines peripheral defocusing. Peripheral defocusing is the difference between the optical forces of the central and peripheral spherical parts, determined along the distribution curve of the optical power in the peripheral part, and is a function of the optical power of the central spherical part.

Another aspect of the present invention relates to a method of slowing the development of myopia of the eye, comprising placing on the eye an ophthalmic device, for example, a contact lens containing a central spherical part with a given optical power, determined by the degree of myopia, and also containing a peripheral part with a given distribution of optical power, which provides myopic defocusing and distribution of optical power in which determines peripheral defocusing, where peripheral defocusing is presented spin precession is a difference between the optical powers of the central spherical part and the peripheral part, along the curve defined by the optical power distribution at the peripheral portion, and is a function of the optical power of the central spherical portion.

Another aspect of the present invention relates to an ophthalmic device, for example, a contact lens designed to slow the development of myopia of the eye and containing a central sphere-cylindrical part with a given optical power, determined by the degree of myopia, and also containing a peripheral part with a given distribution of optical power, which provides a relative refraction in the peripheral region of the eye and the distribution of optical power in which determines peripheral defocusing, where the peripheral def occlusion is the difference between the optical powers of the central sphero-cylindrical part and the peripheral spherical part, determined along the distribution curve of the optical power in the peripheral part, and is a function of the optical power of the central sphero-cylindrical part.

In an improved embodiment of the present invention, within the framework of the above aspects, peripheral defocusing can be determined by the average value of relative refraction in the peripheral region established for any population group and expressed in terms of the optical power of the spherical part. Peripheral defocusing can be approximately described by a linear first-order equation as a constant function of the optical power of the central spherical part, or it can be a non-linear function and increase non-linearly or decrease depending on the optical power of the central spherical part. Peripheral defocusing up to 30 degrees from the central axis can be approximately 0.25-4.00D, and peripheral defocusing up to 40 degrees from the central axis can be approximately 0.5-6.00D. Thus, an ophthalmic device can be part of a sequence of ophthalmic devices, including an ophthalmic device with medium peripheral defocusing, an ophthalmic device with peripheral defocusing above the average and an ophthalmic device with peripheral defocusing below the average, and the average peripheral defocusing is determined by the average value set for any group population.

These and other features and advantages of the present invention will become apparent from the following drawings and detailed description, and their implementation is possible through various elements and combinations indicated, in particular, in the attached claims. It should be understood that both the above summary of the invention, and the following brief description of the drawings and a detailed description of the invention are examples explaining preferred embodiments of the invention and not limiting the scope thereof presented in the claims.

Brief Description of the Drawings

The drawings show:

figure 1 is a schematic sectional view of the emmetropic human eye, showing various incident rays of light and explaining the meaning of the terms used in the present description,

figure 2 is a diagram similar to that shown in figure 1, but illustrating, in an enlarged image, the refractive errors of a typical myopic eye,

figure 3 is a diagram similar to that shown in figure 2, but illustrating the use of a conventional lens for correcting refractive error in the central region,

4 is a diagram similar to that shown in figure 2, but illustrating the use of anti-myopia contact lenses,

5 is a diagram similar to that shown in figure 2, but illustrating the use of the invoice and conventional eyeglass lenses as a composite anti-myopia lens,

6 is a scattering diagram of the equivalent optical power of the corrective sphere required for peripheral rays in the temporal region of the retina, depending on the equivalent optical power of the corrective sphere in the central region for the naked eye, obtained from a wide survey of young myopes in Australia and China,

Fig. 7 is a scattering diagram of the equivalent optical power of the corrective sphere required for peripheral rays in the nose quadrant of the retina, depending on the equivalent optical power of the corrective sphere in the central region, obtained from the survey (see Fig. 6),

Fig. 8 is a scattering diagram of the equivalent optical power of the corrective sphere required for peripheral rays in the upper quadrant of the retina, depending on the equivalent optical power of the corrective sphere in the central region, obtained from the survey (see Figs. 6 and 7),

Fig. 9 is a scattering diagram of the optical correction power in the central region depending on the optical correction power in the peripheral region (mid-horizontal) and the optical correction power in the central region depending on the optical correction power in the peripheral region (in the temporal quadrant) with the best empirical linear regression curves shown for each case, obtained from the survey results (see Fig.6 and 7),

figure 10 is a scattering diagram of the optical correction power in the Central region depending on the optical correction power in the peripheral region (horizontal) and the optical correction power in the Central region depending on the optical correction power in the peripheral region (in the nasal quadrant) with the best empirical linear regression curves shown for each case, obtained from the survey results (see Fig.6 and 7),

11 is a diagram of the scattering of the optical correction power in the middle horizontal depending on the optical power of the correction in the spherical Central region, obtained from the survey (see Fig.6),

Fig is a table compiled on the basis of the survey results presented in Fig.6-11, and establishing the relationship between the measured refractive errors in the Central region and the median refractive errors in the peripheral region with different sets of characteristics of anti-myopia lenses,

Fig.13 is a table compiled on the basis of the survey results presented in Fig.6-11, and establishing the relationship between the measured refractive errors in the central, nasal and temporal regions with various additional sets of characteristics of anti-myopia lenses,

Fig.14 is a graph showing the curves of the magnitude of the peripheral defocusing of four samples of contact lenses, the design of which is consistent with the "Moderate" option from the table in Fig.12,

Fig - schematic representation of a set of lenses for pre-selection, consisting of two parts and suitable for use by a practitioner with the goal of both correction and slow the development of myopia in a patient,

Fig is a schematic illustration of a set, kit or stock of contact lenses applicable for the preliminary selection and dispensing of contact lenses,

17 is a schematic illustration of a small set of false eyeglass lenses,

Fig - data on autorefraction in the Central and peripheral regions of the emmetropic eye, where the optical power (D) is plotted along the Y axis, and the deviation (in degrees) from the central axis is plotted on the X axis,

Fig.19 - data on autorefraction in the peripheral region of the eye with - severe myopia (with subjective refraction in the central region of approximately -6.00D), where the optical power (D) is plotted along the Y axis, and the deviation (in degrees) along the X axis from the central axis

Fig - data on autorefraction in the peripheral region of the eye with myopia (with subjective refraction in the central region of approximately -1.50 D) and autorefraction in the peripheral region through a soft contact lens with a large value of peripheral defocusing, where the optical power is plotted along the Y axis (D ), and on the X axis - the deviation (in degrees) from the central axis,

Fig.21 - data on autorefraction in the peripheral region of the same eye with severe myopia as in Fig.19, and autorefraction in the peripheral region through a soft contact lens with a large value of peripheral defocusing, where the optical power (D) is plotted along the Y axis, and the x-axis is the deviation (in degrees) from the central axis,

Fig. 22 shows the results of a Schmid study in which the optical power of a sphere in a negative cylindrical view was measured in the center and at an angle of 20 degrees in the nasal, temporal, lower and upper quadrants of the retina, where the optical power (D) in the central spherical part, and along the Y axis, the difference in optical power (D) in the peripheral part,

Fig - a more detailed presentation of the results of the Schmid study with separately shown graphs for the nasal, temporal, lower and upper quadrants, where the optical power (D) in the central spherical part is plotted along the X axis, and the optical power difference (D is shown on the Y axis) ) in the peripheral part,

24 is a representation of the effect of peripheral refraction by spherical refraction and spherical equivalent with a given quality of lateral vision,

25 is a graph of a change in the spherical equivalent of refraction in the central region relative to the refractive difference between the values for the central region and the nasal region with a 30 degree deviation obtained by the method of autorefraction (for refraction in the spherical meridian and spherical equivalents),

26 is a graph of a change in the spherical equivalent of refraction in the central region relative to the refractive difference (spherical equivalent) between the values for the central region and the nasal region with a deviation of 30 degrees obtained by the method of autorefraction for the two examined population groups,

Fig. 27 is an example of a lens selection scheme with a target correction value of "Low", "Medium" and "High."

Detailed Description of the Invention

Figure 1 shows a greatly simplified schematic sectional view of a normal left human eye 10 containing a cornea 12, an iris 14, a lens 16, a retina 18, a visual axis 20, where the line defining the nasal plane between the eyes (or the middle visual axis), denoted by 21. The retina 18 is divided into (I) the central region 22 (blacked out), providing central vision and including the central fossa - the most sensitive part of the retina, and (II) the annular peripheral region 24 (pin ikhovan), significantly larger than the central region 22, but less sensitive. In the normal or emmetropic eye, when looking directly (along the 20 axis) into the distance, the central axial beam of 26 light rays from a distant object is focused at the f point of the central fossa in the middle of the central region 22 of the retina 18, which ensures good optical sharpness (visual acuity) . At the same time, the peripheral, or off-axis, beam of light rays 28 from a distant object is focused at a point p of the peripheral region 24 of the retina, while it is assumed that the central beam 28a of the peripheral beam 28 intersects with the visual axis 20 in the axial center n of the pupil 14 (sometimes referred to as the nodal point of the eye 10). If the gaze is directed along the visual axis towards a close object, then the shape and optical power of the lens 16 (this process is called “accommodation”) changes, which, ideally, also ensures focusing of the beam 26 from a close object at point f. Similarly, an off-axis beam 28 from a nearby object is ideally focused at point p of the peripheral region 24 of the retina. In fact, astigmatism is usually inherent in the emmetropic eye with respect to peripheral off-axis objects, which is expressed in the presence of two somewhat shifted foci next to p in the peripheral region of the retina for images of both close and distant objects.

From figure 1 it follows that the peripheral bundle 28 enters the eye 10 from the temporal side (or in the temporal quadrant) of the eye (and head) and focuses on the nasal side (or in the nasal quadrant) of the peripheral region 24 of the retina. In contrast, peripheral rays entering the eye 10 in the nasal quadrant (not shown) fall on the temporal quadrant of the peripheral region 24 of the retina. Of course, peripheral rays can enter the eye in the upper (upper) or lower (lower) quadrants.

Smith et al. Showed that defocused images in the peripheral region of the retina 24 are an important stimulus for stabilizing eye growth. In line with this, measuring the refractive power of the eye at certain angles to the axis is currently considered critical for the correct lens assignment to patients suffering from progressive myopia. In the present description, the angle α at which the central beam 28a of the peripheral beam 28 intersects the axis 20 at point n is called the angle of the off-axis peripheral beam or beam. Due to refraction in the cornea 12 and the lens 16, the angle β, which the outgoing central peripheral ray 28b makes with the optical axis 20 inside the eye 10, is smaller than the angle α, and it is difficult to determine in the patient using conventional tools. It should be noted that the axial gap between the front surface of the cornea 12 and the plane of the iris 14, often referred to as the depth of the anterior chamber (GPC), is usually taken to be 3.5 mm. This gap in FIGS. 1-3 is indicated by ACD (from the English anterior chamber depth) and is used to measure the optical power of the peripheral zone of anti-myopia lenses.

Our studies suggest that at a dip angle α equal to 30 degrees in any meridian, the p point is located far enough in the peripheral region of the retina to provide the necessary stimulus for the growth of the eye, but the inclination is not such that it creates too much difficulty for use . The angle α can actually be considered as a solid angle. Accordingly, in our extensive examination of young myopes in Australia and China, a peripheral beam incidence angle α of 30 degrees was used to measure peripheral refraction of the armed and unarmed eyes. The results of this examination were then used to design and test corrective symmetric and asymmetric anti-myopia lenses for a wide range of myopic patients.

Figure 2 shows a diagram basically similar to that shown in figure 1, but showing, in a very greatly enlarged image, the myopic eye 10a, which, moreover, has a predisposition to progressive myopia (identical elements in this drawing and in FIG. 1 are denoted by the same reference numbers). The axial length of the eye 10a is too large for accommodation that would allow the axial beam 26 to be focused from a distant object in the central region 22 of the retina. Instead, it focuses at f in front of the central region of the retina 22, so the image is defocused. For convenience, this problem is usually referred to as a "refractive error", since correction in this case can be carried out by selecting a lens with negative optical power (see Fig. 3). However, typical for myopes is the ability to focus rays from close objects located on the visual axis in the central region 22 of the retina, which ensures good near vision. One more refractive error typical of the myopic eyes is characteristic of the eye 10a - peripheral hyperopic defocusing, in which the off-axis beam 28 is focused at the point p 'behind the peripheral region 24 of the retina. Smith et al. Have shown that hyperopic defocusing increases factors that stimulate excessive eye growth and contribute to the development of myopia.

Figure 3 shows the myopic eye 10a, armed with a conventional corrective lens. Although a spectacle lens 30 is shown in the drawing, the same considerations can be applied to conventional contact lenses. The lens 30 has a negative optical power, which provides good central vision correction due to the accommodation of the lens 16, which allows the axial beam 26 to be focused from a distant object at the f point of the central fossa. However, the lens 30 shifts the focus of the off-axis beam 28 to the point p ′ ′ behind the peripheral region 24 of the retina, creating an even greater incentive for continued eye growth and the development of myopia. Figure 4 illustrates the effect on the myopic eye 10a of an anti-myopia corrective lens, in this case a contact lens 32. Lens 32 has a central optical zone 32a, the size of which roughly corresponds to the size of the pupil (usually 4-5 mm in diameter in young people in standard room lighting), which provides correction of central vision due to accommodation of the lens 16, which makes it possible to focus the axial beam from a distant object at point f of the central region of the retina 22. The lens 32 has an annular peripheral therapeutic zone 32b surrounding the central zone 32a, with a myopic defocusing value sufficient to focus the peripheral beam 28 at point p '' in front of the peripheral region 24 of the retina, thereby creating an incentive to slow the growth of the eye and develop myopia of the eye 10a. However, a defocused peripheral image may cause peripheral blur.The contact lens 32 has a non-optical zone 32c surrounding the peripheral zone 32b and increasing the accuracy of the fit and ortnost.

FIG. 5 illustrates the conversion of a conventional spectacle lens 30 shown in FIG. 3 into an anti-myopia lens with the same action as contact lens 32 by adding a focal lens 34. Lens 34 has a non-refracting central optical zone 36 that does not affect by the amount of refractive power of the central zone of the base spectacle lens 30, so that the central beam 26 can still be focused at a point f of the central fossa in the central region 22 of the retina. In this case, the false lens 34 has an annular peripheral refractive zone 38 with positive optical power, which creates, despite the negative optical power of the lens 30, peripheral myopic defocusing sufficient to focus the off-axis peripheral beam 28 at point p '"in front of the peripheral region 24 of the retina (as in the case of the contact lens 32 in Fig. 4). The patch lens 34 can be attached to the base lens 30 (or to the spectacle frame not shown in the drawing) using mechanical clamps 40 or suitable glue.

It will be clear to those skilled in the art that there are well-known methods for measuring the refractive forces of various zones of multi-zone lenses in various quadrants, due to which it is possible to determine the focal points of the peripheral and central zones for the armed and unarmed eyes. International patent applications WO / 2008116270 and PCT / AU2008 / 000434, Erhmann and others, respectively, describe a methodology for compiling a distribution pattern of the refractive power of lenses and eyes at large angles of incidence of peripheral beams.

The authors conducted extensive surveys of young people in Australia and China, during which they measured the refractive error in the peripheral region at an angle of incidence of 30 degrees in the nasal, temporal, and upper quadrants of the retina, confirmed that most of them (but not all myopes) had hypermetropic defocusing, but its magnitude was not so great and did not increase so sharply in the case of high myopia, as expected. Data on the examined myopic eyes are summarized in graphs or scattering diagrams shown in Fig.6-11, where the refractive power of the eye is measured in terms of the spherical equivalent and where all measurements in the peripheral region were performed in different quadrants at an angle of incidence of 30 degrees. The following is a discussion of these graphs.

Figure 6 shows a graph of the dependence of the optical correction power in the peripheral region (in spherical equivalent) for the examined eyes at 30 degrees in the temporal quadrant of the optical correction power in the central region (along the axis and also in the spherical equivalent), which is generally linear . The graph shows the presence of a scatter equal to 3D for the peripheral focus in the case of moderate (better than -2D) myopes, and for most eyes there is a relative hyperopic defocus in the peripheral region. People with hyperopic defocus should be considered at much greater risk of progressive myopia than people with myopic defocus. Similar results are found for measuring the optical power of correction in the nose and upper quadrants (Figs. 7 and 8, respectively), but with a significantly wider spread of values, especially in the upper quadrant. Figures 9 and 10 summarize the data on the optical correction power in the temporal and nasal quadrants, shown in Figs. 6 and 7. Fig. 9 shows graphs of the dependence of the optical correction power in the central region on the optical correction power in the peripheral region (horizontal horizontal). ) and the optical correction power in the central region from the optical correction power in the peripheral region (in the temporal quadrant) with the best empirical linear regression curves shown for each case. Figure 10 presents graphs of the dependence of the optical correction power in the central region on the optical correction power in the peripheral region (mid-horizontal) and the optical correction power in the central region on the optical correction power in the peripheral region (in the nasal quadrant) with the best empirical linear regression curves shown for each case. Finally, from the graph of the dependence of the optical correction power in the middle horizontal on the optical correction power in the spherical central region presented in FIG. 11, it is seen that almost all the examined groups fall within the range of 3D. Obviously, these data confirm the main point of the present invention, namely, that the optical power of the peripheral zone of anti-myopia lenses for normal myopes can be set in accordance with the optical power of the central zone without peripheral defocusing exceeding 3D, which eliminates the need for measuring peripheral refractive index eye errors and the appointment of selected lenses for the correction of central refractive error and the corresponding change in peripheral refraction for therapeutic purposes.

In addition, these data can be presented in a more concise form - in the form of convenient look-up tables or rules of thumb for approximate calculations that establish a median-median difference between the optical forces of the spherical parts in the central and peripheral regions of rotationally symmetrical lenses (Fig. 12) or rotationally asymmetric lenses having different optical power in the temporal and nasal quadrants (Fig.13).

As can be seen from the table shown in Fig. 12, in its leftmost column "Refractive error in the central region (D)", the values of the measured refractive error in the central region are given in increasing increments from + 0.25D to + 6.00D for the naked eyes surveyed populations. In the second column on the left, “Median refractive error in the peripheral region (D)”, the median median values of the measured refractive error in the peripheral region are given at an angle of incidence of 30 degrees. So, in myopes, -0.25D (with a refractive error of + 0.25D in the central region), on average, hyperopia -0.71D was found in the peripheral region, and in myopes of -5D from this population (with a refractive error of +5 , 00D in the central region) was found, on average, myopia + 2.83D in the peripheral region. In the third column "Median appointments for the examined group in the central / peripheral region (D)" of the table in Fig. 12, the absolute central and peripheral defocusing of the lenses, selected, on average, for a specific part of the examined population group with corresponding refractive errors in the central and peripheral areas shown in the first two columns of FIG. Thus, a -0.25D myope (with a measured error in the central region of + 0.25D) needs a lens with an optical correction power of -0.25D in the central zone and peripheral defocusing of + 0.96D to ensure (I) good central vision and ( Ii) focusing the peripheral beam (at an angle of incidence of 30 degrees) in front of the retina in order to eliminate, to a large extent, the stimulus for excessive eye growth. Similarly, a -5.0D myope needs a lens with optical power correction in the central area of -5.00D and peripheral defocusing + 2.17D to provide good vision and eliminate, to a large extent, the stimulus for eye growth. Therefore, the third column in FIG. 12 defines sets, kits or funds of finished anti-myopia lenses with a minimum predetermined optical power in the peripheral zone. Rotationally symmetrical lenses may be suitable for this.

In the two-part fourth column “Steps of the addition of optical power / defocus in the peripheral zone of the lens (D)” of the table in Fig. 12, the options “Moderate” and “Strong” (levels of peripheral defocus) can be used, which can be used to obtain the corresponding average and high levels of correction to slow down eye growth. In the “Moderate” version, four discrete peripheral defocus stages correspond to additives + 1.00D; + 1.50D; + 2.00D and + 2.50D, which increase the level of defocusing of lenses with minimal correction, indicated in the third column in Fig. 12, while in the Strong version, additives of + 1.50D correspond to four levels of peripheral defocusing; + 2.00D; + 2.50D and + 3.00D. Peripheral defocus stages (that is, when several lenses with the same optical power in the central zone have different optical power in the peripheral zone) are used to simplify the understanding by patients, doctors and manufacturers. In the case of the fourth column of FIG. 12, rotationally asymmetric lenses are suitable.

The table in FIG. 13 provides information useful in the manufacture of rotationally asymmetric lenses with different optical powers in the temporal and nasal quadrants. In its leftmost column, “Refractive error in the center, region (D)”, again, the values of the measured refractive error in the central region are given here in increasing increments from + 0.25D to + 6.00D (for myopes from -0.25D to -6 , 0D). In the second column on the left, "Median refractive error in the temporal quadrant (D)", the median values of the measured refractive error in the temporal quadrant are given for those populations for which the corresponding increments of the measured refractive error in the central region take place, shown in the left extreme column on Fig.13. In the third column on the left, “Median refractive error in the nasal quadrant (D)”, the median values of the measured refractive error in the nasal quadrant are given for patients with corresponding increments of the measured refractive error in the central region, shown in the left extreme column. Note that the examined populations showed slightly greater hyperopia in the temporal part of the retina than in the nasal, which suggests the usefulness of using measurements in the temporal quadrant. The fourth column "Median appointments for the examined group in the central / temporal region" of the table in Fig. 13 can be considered as a defining set of asymmetric anti-myopia lenses with therapeutic minimum optical power in the temporal quadrant of the retina, the second values of optical power in the column being peripheral defocus in this quadrant. It should be noted that for exposure to the temporal quadrant of the retina, the lenses must have some peripheral defocusing in their nasal quadrant. Similarly, the fifth column "Median appointments for the examined group in the central / nasal region" of the table in Fig. 13 can be considered as a defining set of asymmetric anti-myopia lenses with therapeutic minimum optical power in the nasal retinal quadrant. And in this case, it should be noted that for exposure to the nasal quadrant of the retina, the lenses from the fifth column kit must have some peripheral defocusing in their temporal quadrant.

In the two-part fourth column, “Steps of optical power addition in the peripheral zone” of the table of FIG. 13, the steps of peripheral defocusing values that can be used to change the peripheral defocusing of lens sets of the fourth and fifth columns are indicated. It can be seen that in the part of the column entitled "The selected value of the optical power / defocus in the temporal quadrant", for lenses from the "temporal set", the optical power of correction (peripheral defocus) in the temporal quadrant is incremented by four discrete steps, namely +1.5 D ; + 2.0 D; +2.5 D and +3.0 D, while on the right side of the column entitled “Selected optical power / defocus in the nasal quadrant”, for lenses from the “nasal kit”, the increment of peripheral defocus is carried out by three discrete steps, namely + 1.0 D; +1.5 D and +2.0 D. And in this case, when considering the design of the lens, one should take into account that in order to achieve the desired changes in the temporal and nasal quadrants of the peripheral region of the retina, it is necessary to obtain a certain peripheral defocus in the nasal and temporal quadrants of the lenses, respectively. The lenses from the fourth column "Steps of the addition of optical power" of the table in Fig.13 are, of course, rotationally asymmetric.

On Fig presents comparative curves of optical power for each of the four stages of peripheral defocusing of contact lenses, the design of which is consistent with the "Moderate" option from the table in Fig. 12 (fourth column). The maximum peripheral defocusing of the lenses from this subset or option is 2.5D. The reference signs (60a, 61a, 62a and 64a) of the optical power curves are used in the description below shown in Fig. 15 and consisting of two parts of a set of lenses for pre-selection.

On Fig presents a schematic representation of a set or set of lenses for pre-selection or prescription, consisting of two parts and suitable for use by a practitioner, which can be replaced by conventional, somewhat more expensive sets and which may include a set or set of finished spectacle lenses for selection or a set or set of contact lenses for selection or vacation. This drawing can be considered as a schematic view in horizontal projection of a separate drawer or tray 50, in which the lenses are placed on the same level in two groups, or parts, 52 and 54, or it can be considered as a schematic view in vertical section of a cabinet 50 with two drawers , or parts, 52 and 54, located one above the other. The lenses of part 52 correspond to the values indicated in the “Moderate” column, the second to the right, while the lenses of part 54 correspond to the values indicated in the “Strong” column, the far right, of table 12. Thus, lenses in amount twice the minimum necessary for a set covering "normal myopes" up to -5.00D. In this example, each of the lenses 58a and 58b is packaged in a suitable sachet (not shown separately).

In Fig. 15, part 52 is made in the form of a container 56a with cells containing 20 different lenses 58a covering the range of optical correction power in the central zone to -5D with an increment of -0.25D, while part 54 is made in the form of container 56b with cells , also containing 20 different lenses 58b, covering a range of optical power correction in the Central zone up to -5D with increments of -0.25D. The corresponding increment of the optical power in the central zone is indicated above the lenses 58a of part 52 and is indicated by the bracket 59a (for lenses 58b of part 54, by bracket 59b), the Peripheral defocusing of lenses 58a is jointly indicated by bracket 57a, and lens 58b by bracket 57b. Containers 56a and 58a may have different color codes (for example, container 56a may be yellow and container 58a red), while sachets for all lenses in each container may be similarly distinguished using the same color codes, as well as marking them with the indication of the optical power in the central zone and peripheral defocusing inside the lenses, in order to minimize the likelihood of improper placement of the lens in the set 50 or improper selection of bag / lens for pr dvaritelnoy fitting or use. For ease of use, the lenses 58a and 58b are located in their respective containers 56a and 56b according to the values of the increment of the optical power in the Central zone, although this is not necessary in the case of the linear model shown in Fig.15. In this example, the lenses 58a of part 52 together include four stages of the optical power of the peripheral zone and, therefore, form four sub-sets indicated by brackets 60a, 61a, 62a and 64a (the design of these lenses corresponds to the optical power curves in Fig. 14). Peripheral defocusing of each sub-set is determined on the diagram by the height of the shaded area of each lens and the numerical value of the optical power with a plus sign associated with each bracket. So, sub-set 60a includes three lenses 58a, each of which has a peripheral defocus of 1.0D, sub-set 61a includes 8 lenses with a peripheral defocus of 1.5D, a sub-set of 62a-4 lenses with a peripheral defocus of 2.0D and a sub-set of 64a - Five 2.5D peripheral defocus lenses. Similarly, part 54 comprises four sub-sets 60b, 61b, 62b and 64b, respectively, with three, eight, four and five lenses 58b and peripheral defocus steps + 1.5D; + 2.0D; + 2.5D and + 3.0D.

A set or set of 50 lenses can be used as follows. The practitioner carries out the usual assessment (measurement) of refractive error in the central region of the patient’s eyes using existing equipment and well-known techniques used to prescribe conventional corrective lenses, and looks at the patient’s medical history in order to determine if he has progressive myopia. In the case of a negative answer, a lens is selected and tried from part 52 of set 50 with the appropriate optical correction power in the central zone, in the case of a positive, the lens from part 54. If the patient is not satisfied with the degree of clarity of the central vision provided by the selected lens, try a lens with the following adjacent value optical power in the central zone from the same part of the set. If, as a result of a trial selection of the lens from part 54 to the patient, he finds that the peripheral blur is too large, this lens can be replaced by a lens with the same optical power in the central zone from part 52 of the set. In any case, a high degree of doctor’s confidence is ensured that the action of the selected lens will slightly slow down the development of myopia in the patient by focusing the peripheral beam on or in front of the retina in order to create the necessary incentive to slow down further eye growth. If kit 50 is a kit of contact lenses, it can be used to dispense finished lenses to patients or to develop an appropriate supply chain for wholesale suppliers or manufacturers. If kit 50 includes ready-made spectacle lenses for selection, and the clinic has its own equipment for the final grinding and / or polishing of lenses, then it can provide patients with finished lenses; otherwise, it routinely places orders for such lenses with manufacturers.

Two other types of kits, kits or funds formed in accordance with the principles of the present invention are shown in FIGS. 16 and 17. FIG. 16 shows two different sets of contact lenses, sets or stocks 70a and 70b, each of which contains a box, a tray or a drawer 72 with a plurality of cells 74, which houses sachets 76 with contact lenses (not shown separately) having the same optical correction power in the central zone. For convenience, only four sachets 76 are shown in each cell 74. The optical power of the central area of the lenses in each cell 74 is indicated on labels 78 attached above or below the cells. It can be seen that this optical power is in the range from -0.25D to -6.0D in increments of 0.25D.

In the kit, kit, or stock 70a, the sachets 76 in each cell 74 have the same optical power not only in the central but also in the peripheral zone, that is, the lenses in each cell are identical, so that they can serve as a test kit fit and stock for the holidays. On each bag, the optical power in the central zone is clearly indicated, and since in this example the optical power in the peripheral zone is not required, in the preferred embodiment, all the bags in the set have an encoding (for example, color), indicating that they belong to one unified series or to one type of kit. The optical power in the peripheral zone of the lenses in the cells corresponds to the average median values of the optical correction power in the central zone for the examined population groups indicated in the third column of the table in Fig. 12. This means that not a single pair of lenses from the stock or set 70a with different optical powers in the central zone will have the same optical power in the peripheral zone; on the contrary, each optical power of the central zone is associated with a unique optical power of the peripheral zone. Therefore, lenses from a kit or stock 70a have a minimal beneficial therapeutic effect. In the kit, kit, or stock 70b, in each cell 74, lenses are arranged with several therapeutic levels but with the same optical power in the central region indicated on the label 78 of the cell. Each bag 76 of each cell is provided with a marking indicating the level of therapeutic effect and, in a preferred embodiment, the optical power in the central and peripheral zones and the degree of exposure. In this example, each cell 74 contains sachets 76 with four different degrees of exposure, the lowest of which is the one mentioned in connection with the above set 70a and taken from the third column in FIG. 12, the second low is taken from the penultimate column in FIG. .12, the second highest is from the penultimate column in Fig. 13 and the highest is from the last column in Fig. 13. This lens kit, kit or lens stock is then used mainly similar to the kit or kit 50 described in relation to FIG. 15, except that the doctor is given greater discretion in prescribing in accordance with his assessment of the patient’s predisposition to progressive myopia based on the medical history of the latter, which, of course, includes a family history of myopia.

The last example of a kit or kit 80 for selecting lenses, consisting of seven false eyeglass lenses 82, is shown schematically in FIG. 17, where this kit or kit 80 comprises a stand 84 with compartments or recesses 86 in which false lenses with a non-refracting central zone and various levels / levels of optical power or defocusing in the peripheral zone. In this case, compartments 86 are provided with labels 88 indicating the level / level of added optical power or defocus in the peripheral zone, which is in the range from + 1.0D to + 2.5D with incremental increments of 0.25 D and corresponds to the option of adding peripheral defocus " Moderate "in the table of Fig. 12 (with the exception of steps with increments of less than 0.25). Since not all attached lenses 82 of set 80 may have a common base curve, and other similar sets with lenses having different base curves can be used, it is convenient to additionally identify the base curve of each attached lens using labels 90. However, as in the previous examples, it is also desirable to mark with the indication of the optical power of the peripheral zone and the baseline curve on the lenses or their bags (if provided).

The principle of using the kit or kit 80 is similar to that described for the kit or kit 50 (FIG. 15). The practitioner checks the refractive error in the central region of the patient’s eyes, estimates the patient’s predisposition to progressive myopia based on the history of his illness, selects false lenses with a degree of exposure or peripheral defocusing corresponding to the estimated predisposition, and performs a trial fit of the selected false lenses to the lenses of the patient’s everyday glasses or to test base lenses with the corresponding optical power in the central zone. If the patient finds that the peripheral blur is too great, a false lens is tried with the next low level of peripheral defocus, and so on until the patient receives approval. In conclusion, an eyeglass lens is ordered or processed using existing equipment for grinding and polishing. The ability to provide so many levels of peripheral defocusing with a small kit or set of lenses is an obvious advantage.

Turning now more specifically to the anti-opioid ophthalmic devices themselves and, more specifically, to ophthalmic lenses (such as contact lenses), it is possible, as mentioned above, to represent the optical power in the peripheral zone by distribution, where it varies with the radial distance in such a way that it the distribution shows the magnitude of the optical power at the points of the peripheral zone located at a certain distance from the central axis. Previously, this distribution of optical power in the peripheral zone of ophthalmic lenses was left unchanged or changed in order to reduce image distortion in glasses and improve central vision. Due to the lower visual acuity inherent in the peripheral region of the retina, the correction of refraction in this area was not considered a significant improvement.

As mentioned above, peripheral defocusing is determined by the difference between the optical forces in the central and peripheral zones of the ophthalmic lens at a specific point on the distribution curve of optical power in the peripheral zone. The ophthalmic device according to the present invention assumes that the lens has differential optical power (peripheral defocusing of the lens), which is a function of the optical power in the central spherical zone. However, in children and adults, significant individual variability of differential refraction (peripheral minus central) was observed with comparable refraction in the central region. As a result, the use of anti-opioid ophthalmic / contact lenses with an average (single) value of peripheral defocusing / differential optical power can lead to excessive correction in the peripheral region of the retina in some myopes and to insufficient correction in others, depending on the individual peripheral defocusing of a particular eye. The optical effect of insufficient correction can be expressed in the presence of some residual hyperopic defocus in the peripheral region of the retina, which can also create an incentive for axial growth of the eye and worsen the situation with myopia. On the other hand, the optical effect of significant excessive correction in the peripheral region of the retina can be expressed in excessive magnitude of myopic peripheral defocusing, which can not only complicate, but also worsen peripheral vision, which may result in further axial growth of the eye and progressive myopia. The use of anti-myopia contact lenses with a single value of peripheral defocusing / differential optical power exceeding the average value at which in most patients with progressive myopia peripheral hyperopia turns into peripheral myopia would prevent insufficient correction in some myopes, but would lead to a significant excessive correction in others with the consequences mentioned above.

In a series of lenses according to the present invention, each lens has a differential optical power (a value of peripheral defocusing) focused on achieving average relative refraction in the peripheral zone for a given optical power in a spherical central zone. You can get a lens with a value of peripheral defocusing in excess of the average value. Alternatively, you can get a lens with a peripheral defocus value below the average value. This means that although the peripheral defocusing of the lens can be above or below a certain average value, the magnitude of the peripheral defocusing varies as a function of the specific optical power in the spherical central zone so as to obtain lenses that provide adequate correction of deviations in the level of refraction in the peripheral region. In an alternative embodiment, the ophthalmic lenses can be adapted to a particular patient based on their level of refraction in the peripheral region. In this case, it is possible to manufacture lenses for a particular patient after determining the required value of peripheral defocusing / differential optical power of the lenses.

The relationship between the optical power in the central zone and the peripheral defocusing of the lens can be described by at least a first-order linear equation, so that peripheral defocusing increases as a constant function of the optical power of the central spherical part of each lens. Although the linear dependence is consistent with the found dependence between refractions in the central and peripheral regions, here it is possible to go over to higher-order equations or to non-polynomial dependencies in order to obtain a nonlinear dependence providing greater accuracy. The result is an increase in peripheral defocusing from the minimum value for mild myopia (-0.25 D) to the maximum value for strong myopia (-30.00 D) or to a value limited by the optical design parameters of the lens. This is the difference from other types of optical correction, for example, in presbyopia, where the decrease in accommodation does not depend on the degree of myopia. In the case of presbyopia correction, there is no increase in additional optical power as a function of refractive myopia. This dependence provides greater accuracy of the changes in refraction in the peripheral zone than in the case of using a lens with peripheral defocusing, which has a fixed value. This dependence is based on experimental results, which indicate that upon transition from the central region of the eye to peripheral refraction, it can increase with the degree of myopia. In relation to the range of optical power of existing anti-myopia lenses, one should use an experimentally determined average value of refraction (for the central and peripheral zones) as a function to calculate optical peripheral defocusing for each value of the optical power of the spherical part of the lens.

The results of an additional study of refraction in the peripheral region of the eyes, obtained at the CIBA Vision research clinic, showed that with the highest hyperopic refraction, the position of the focus (in the spherical meridian) of the myopic eye can vary in the range of the difference from the minimum value of 0.25D to about 4 , 00D (at -6.00D; for higher values of negative optical power, an even greater value is expected) in relation to the deviation from the central axis at the angle of incidence of the off-axis beam, avnom 30 degrees. In a more preferred embodiment, for an off-axis beam incident at an angle of 30 degrees, this range can extend between approximately 0.25 D and 3.0 D, and in an even more preferred embodiment, between approximately 0.25 D and 2.5 D. to a deviation from the central axis when the angle of incidence of the off-axis beam is 40 degrees, this difference increases and the range can extend between approximately 0.50 D and 6.00 D. Optical design evaluation of soft contact lenses in which peripheral defocusing was more positive showing la the possibility of correcting high (2.50 D) differential refraction (see Fig. 20). However, a lens with the same peripheral defocusing, worn on the eye with a differential refraction of 0.75 D, produces an excessive correction of refraction in the peripheral region, leading to peripheral blurring felt by the patient.

On Fig presents data on autorefraction in the Central and peripheral regions of the emmetropic eye. The relative hyperopia in the peripheral region of such an eye is very small (less than 0.50 D at 30 degrees), and for this particular case, the relative hyperopia in the peripheral region is -0.62 D (at an angle of incidence of an off-axis beam of 30 degrees) minus -0.62 D (on the central axis), which gives 0.00 D.

On Fig presents data on autorefraction in the peripheral region of the eye with a strong myopia and worn - in order to measure by means of an autorefractor - an ordinary soft contact lens. The relative hyperopia in the peripheral region of such an eye is much higher (more than 2.00 D at an angle of incidence of an off-axis beam of 30 degrees), and for this particular case, the relative hyperopia in the peripheral region is 2.75 D (at 30 degrees for an off-axis beam) minus 0, 37 D (at ten degrees for an off-axis beam), giving 2.37 D.

On Fig presents data for an eye with myopia and subjective refraction in the Central region of approximately -1.50 D. Relative hyperopia in the peripheral region for this particular case is low and is -0.25 D (at 30 degrees for an off-axis beam) minus - 1.00D (at ten degrees for an off-axis beam), which gives 0.75 D. Additional data were obtained on refraction through a soft contact lens designed to correct high levels of relative hyperopia in the peripheral region. The action of this corrective lens is expressed here in relative myopia in the peripheral region, which for this particular case is -3.25 D (at 30 degrees for an off-axis beam) minus -2.50 D (at ten degrees for an off-axis beam), which gives - 0.75 D. Like general myopic refractive bias, this change in peripheral refraction was too great and caused a subjective deterioration in peripheral vision.

On Fig presents data on autorefraction in the peripheral region of the same eye with severe myopia (in this case -6.00 D), as in Fig.19, obtained through wearing - in order to measure by autorefractor - corrective lens -4 , 00 D. Additional data were obtained on refraction through a soft contact lens designed to correct high levels of relative hyperopia in the peripheral region, as was done in the case of FIG. The action of this corrective lens is expressed here in a much smaller relative hyperopia in the peripheral region, which for this particular case is -4.25 D (at 30 degrees for an off-axis beam) minus -4.62D (at ten degrees for an off-axis beam), which gives 0.37 D. Along with a smaller general mystical refractive bias, this change in refraction in the peripheral region was insignificant and did not cause subjective deterioration of peripheral vision.

On Fig presents the results of a study of Schmid, in which the optical power of the sphere in the view of the minus the cylindrical component was measured in the center and at an angle of 20 degrees in the nasal, temporal, lower and upper quadrants of the retina using a Shin Nippon K5001 autorefractometer on eyes of six young adult volunteers during cycloplegia. A plot of the dependence of relative refraction in the peripheral region for the optical power of the sphere (the difference between the optical forces in the peripheral and central regions) in each quadrant of the optical power of the central spherical part revealed the presence of an inverse correlation. Statistical significance was achieved for the average values from the combined measurement data in all four quadrants.

On Fig results of the Schmid study are presented in more detail. It can be seen that for all four quadrants there is a tendency towards an increase in relative hyperopia in the peripheral region with an increase in myopia in the central region. For individual quadrants, statistical significance was achieved in the lower and upper quadrants, where the change was somewhat larger.

An analysis of the correlation between a subjective assessment of the quality of vision and objective autorefraction in the peripheral region of the patient’s retina, which reported different quality of vision in lenses with different peripheral defocusing, showed that there are limits of excessive correction beyond which the quality of vision becomes unacceptable. Fig.24 illustrates the effect of refraction in the peripheral zone of the lenses on assessing the quality of lateral vision on a scale of values from 0 to 10. Symbols indicate patients who answered “No” (circles) or “Yes” (triangles) to the question whether these lenses provide quality of vision sufficient to wear them all the time.

The graph shown in Fig. 24 is plotted in units of spherical refraction ("Sph", the left side of the graph) and the spherical equivalent of refraction ("M", the right side of the graph), measured on an autorefractometer at 30 degrees in the temporal quadrant of the retina from the nasal side ("T30 "). If, for example, in the case of measurement at 30 degrees in the temporal temporal quadrant of the retina from the nasal side, the spherical refraction of the lens is less than approximately +0.25 D (i.e., on the retina or in front of the retina), then the quality of vision is unacceptable, which is noted by all patients who responded “No” to the question whether this lens provides a quality of vision sufficient to wear it continuously. This is shown in the graph in the shaded left region of the "T30 Sph" section. Similarly, with a spherical equivalent of refraction lower than about -2.50 D (that is, farther from the front of the retina than at 2.50 D), the quality of vision is unacceptable, which is noted by all patients who answered “No” to the question, provides Is this lens a quality of vision sufficient to wear it continuously (shaded left area of the T30 M site). Therefore, it can be seen that excessive correction of refraction in the peripheral region leads to a decrease in the subjective assessment of vision. In particular, the correction of refraction in the spherical meridian should not lead to a value below +0.25 D, and in the case of the spherical equivalent it should not be lower than -2.50 D. Correlation analysis also showed that lens rejection is mainly caused by the deterioration of peripheral vision in the opposite of the central. The determination and application of these limits of excessive correction significantly facilitates the lens fitting procedure and helps to reduce the likelihood of poor vision and lens rejection by patients when correcting peripheral defocusing and preventing the further development of inadequate eye refraction.

25 is a scatter chart with refraction data for a spherical meridian and spherical refraction equivalent (SEQ) showing the change in the spherical refraction equivalent (in diopters) in the central region relative to the refractive difference (also in diopters) between the values for the central region and the nasal region with a deviation of 30 degrees obtained by the method of autorefraction. These data were obtained for a large group of adults consisting of natives of the Caucasus. As can be seen from FIG. 25, for the spherical equivalent (SEQ) in the central region, the refractive errors are between + 0.50 D and -5.00 D, and there is a significant increase in the refractive difference in the peripheral region with an increase in the degree of myopia. The rate of increase, or steepness, of the best empirical curve for this data is 0.14 D / D in the case of refraction in the spherical meridian and 0.18 D / D in the case of SEQ. The intersection points with the coordinate axis (X = 0, or the refractive error of the non-refracting zone) correspond to + 0.53D for the spherical meridian and 0.05 D for SEQ. Therefore, the target correction, or reduction of the refractive difference in the peripheral zone for the spherical meridian and SEQ, requires approximately the same increase in the values for SEQ in the central zone.

On Fig presents a scatterplot with data on refraction for spherical equivalent (SEQ) in the Central region, shown in Fig.25, which also marks the refraction data for spherical equivalent (SEQ) in the Central region, obtained for a population consisting of children and adolescents - natives of Asia (China). These data are given relative to the refractive difference (also in diopters) between the values for the central region and the nasal region with a deviation of 30 degrees obtained by the method of autorefraction. A comparison of the data for the Caucasian and Asian groups in the range of refractive errors for SEQ between -0.50 D and -4.00 D shows a significant difference in the nature of the increase in refractive difference in the peripheral region with an increase in the degree of myopia. The rate of increase, or steepness of the best empirical curve, for these data is -0.19 D / D for the Caucasian group and -0.35 D / D for the Asian group. Therefore, target correction, or reduction of the refractive difference in the peripheral zone, requires an increase in the values for SEQ in the central zone (as mentioned above with respect to FIG. 25); however, the nature of this increase may vary depending on the composition of the target population or demographic indicators for a given region.

In some embodiments, the change in peripheral defocusing for each value of the optical power in the spherical part may still not provide coverage of the entire range of relative refraction in the peripheral region necessary to match the relative peripheral hyperopic defocusing of all patients with myopia without clinically significant excessive or insufficient correction in some of them. In this case, the target correction parameters of the ophthalmic lens can be consistent with the change in the refractive difference in the peripheral region, and for each value of the optical power in the spherical part, additional variability may be required, for example, with respect to determining the average value (as well as below and above average) of the differential optical power (peripheral defocusing) during the transition from the central region to the peripheral. Although when changing peripheral defocusing with the optical power of the central spherical part, a change in the average relative peripheral hyperopic defocusing is taken into account, higher or lower optical design parameters may be required for the general population to exclude clinically significant excessive or insufficient correction of relative refraction in the peripheral region for individual patients. In the example shown in FIG. 27, the target correction, designated as “Average SEQ”, is to bring the peripheral refractive index SEQ to +0.75 diopters and the additional (higher or lower) target SEQ refractive differences to peripheral regions are indicated by dashed lines designated as “High SEQ” and “Low SEQ”. In this combination, the average value of the differential optical power during the transition from the central region to the peripheral will continue to increase with the negative optical power of the spherical part, providing correction for all cases of an increase in the refractive difference during the transition from the central region to the peripheral with an increase in the degree of myopia.

In an alternative embodiment, negative differential optical power may be provided in the design of the contact lens to provide hyperopic defocusing in the central and peripheral regions of the retina to stimulate axial growth in hyperopic eyes. In yet another alternative embodiment, a sphere-cylindrical central portion for correcting astigmatism is provided in the lens design. In this case, both the spherical component and the spherical equivalent (spherical + half cylindrical) of the optical power of the central zone are used as the optical power of the central spherical part to determine the required peripheral defocusing of the lens. Another alternative implementation of the present invention includes the selection of a lens with a certain amount of peripheral defocusing, based on data on relative refraction in the Central and peripheral areas of the eyes of a particular patient. Such a correction may be associated with the manufacture of custom lenses, and not with the more general case of their selection from the available ones described above. It is clear that specialists in this field can be implemented - within the scope of the present invention defined by the following claims, - numerous modifications of sets, kits or funds of lenses and additions to them, as well as lenses or their components described in the above example.

Claims (36)

1. A kit, kit or stock of prefabricated lenses for use in providing an anti-myopia lens for an eye of a patient with myopia, in which each lens of the kit, kit or stock has a central optical axis and a central optical zone surrounding and including this axis, the central optical zone has the optical power of the refraction correction in the range from weak refraction to -6.0 D, each lens has a peripheral optical zone surrounding the mentioned central zone, the peripheral zone is characterized by a angle of incidence I, which is approximately 30 ° relative to the optical axis, the peripheral zone of each lens has a positive refractive power relative to the refractive power of the central zone of this lens, which ensures myopic peripheral defocusing, the mentioned peripheral defocusing of any lens of a kit, kit or stock does not exceed approximately 3.5 D, and the lenses of the kit, kit or stock are arranged in a certain order, so that the doctor is given the opportunity to choose a lens with optical power for correction and slowing down the development of myopia, without the need for pre-measurement of refractive errors in the peripheral region of the eyes and the individual order of the lens with a desired optical power of the peripheral zone. 2. The kit, kit, or stock of prefabricated lenses according to claim 1, wherein the central optical zone has a negative refractive power for correcting a positive refractive error in the central region of the myopic eye, this negative refractive power in the central zone changes in increments within the kit, kit, or of lenses, the refractive power of the peripheral zone increases with increasing refractive power in the central zone within the set, set or fund of lenses, and the lenses in the set, set or fund are located in -determination procedure according to the magnitude refractive power in the central zone, the peripheral zone and / or peripheral defocus. 3. The kit, kit or stock of prefabricated lenses according to claim 2, in which the increment of the refractive power in the Central zone is approximately -0.25 D, the refractive power in the Central zone of the lenses is in the range from about -0.25 D to about -6.0 D, peripheral defocusing of the lenses changes mainly in proportion to the change in refractive power in the central zone of the lenses in the range from +0.5 D to +3.0 D. 4. The kit, kit or stock of prefabricated lenses according to claim 3, in which the peripheral defocusing of the lenses in the kit, kit or stock increases stepwise with increasing optical power in the Central zone so that several lenses with adjacent increments of optical power in the Central zone and the same peripheral defocusing, which makes it easier for doctors, manufacturers and / or patients to understand or use the lens kit, kit or lens stock. 5. The kit, kit or stock of prefabricated lenses according to claim 2, in which there are several lens sets, where each set contains a number of lenses having the same refractive power in the central zone, but different levels of peripheral defocusing, so the doctor , knowing a positive refractive error in the central region of the myopic eye, is able to conveniently (i) choose a subset of lenses having refractive power in the central zone, which, according to the estimate, will provide the best correction for the mentioned change errors in the central region, (ii) select the lens from the selected sub-set, which according to the estimate has the level of optical power in the peripheral zone that is most consistent with the patient’s estimated predisposition to progressive myopia based on his medical history, and (iii) carry out a trial fit of the selected lens to the patient’s eye in order to assess its tolerance for peripheral blur caused by the selected lens. 6. The kit, kit or stock of prefabricated lenses according to claim 5, in which the lenses in each said sub-set have three levels of optical power in the peripheral zone, corresponding to low, medium and high levels of peripheral defocusing, so that the doctor who finds that the selected lens with an average or high level of peripheral defocusing is not suitable for the patient, then he can choose a lens with the same optical power in the central zone, but with a lower level of peripheral defocusing. 7. The kit, kit or stock of prefabricated lenses according to claim 2, in which the kit, kit or stock lenses are contact lenses for pre-selection or tempering, there are approximately 24 increments of refractive power in the central zone, refractive power in the central zone of the kit lenses , of the kit or stock is in the range from -0.25 D to about -6.0 D, each increment of the optical power in the central zone is about -0.25 D, each lens of the kit, kit or stock has a unique peripheral efokusirovku magnitude peripheral defocus of lenses in the set, kit or fund increases essentially proportionally to the increase in the refractive power of the central zone of the lens set, kit or foundation. 8. The kit, kit or stock of prefabricated lenses according to claim 2, wherein the kit, kit or stock lenses are contact lenses for pre-selection or tempering, there are approximately 24 increments of refractive power in the central zone, refractive power in the central zone of the kit lenses , recruitment or stock is in the range from -0.25 D to approximately -6.0 D, each increment of the optical power in the central zone is approximately -0.25 D, there are at least three steps of refraction or defocusing force in riferiynoy zone, each of these steps corresponds approximately +0,5 D. 9. The kit, kit or stock of prefabricated lenses according to claim 1, in which the lens, daily worn by the patient, has a negative refractive power for correcting refractive error in the central zone of the myopic eye, the lenses of the kit, kit or stock are spectacle lenses for pre-selection and use with a lens daily worn by the patient, each lens of a kit, kit or stock has a non-refracting central zone and an optical power value in the peripheral zone different from the corresponding value other lenses of a kit, kit or stock, each lens of a kit, kit or stock can be aligned coaxially on an everyday lens to fit the eye, the lenses in the kit, kit or stock are arranged in a certain order according to the magnitude of the optical power in the peripheral zone, that the doctor is given the opportunity to conveniently (i) choose a lens from a kit, kit or stock that, according to the assessment, has a level of optical power in the peripheral zone that is most consistent with the patient’s estimated predisposition to gressiruyuschey myopia based on his medical history, and (ii) carry out a trial fit the selected lens in conjunction with a daily lens to the patient's eye to evaluate its tolerance to peripheral blur. 10. The kit, kit or stock of prefabricated lenses according to claim 9, in which the peripheral defocusing of the lenses is in the range between approximately +0.5 D and approximately +2.0 D, the optical power of the peripheral zone of the lenses from the kit, kit or stock varies increments not exceeding approximately +0.5 D. 11. The kit, kit, or stock of prefabricated lenses according to claim 2, wherein the lenses are substantially rotationally symmetrical in that the peripheral defocusing is substantially the same for all quadrants of the peripheral zone of the lens. 12. The kit, kit or stock of prefabricated lenses according to claim 1, wherein the peripheral defocusing of the lenses from the kit, kit or stock refers to the nasal or temporal quadrant of the lens, so that when using any lens from the kit, kit or stock of the patient measured peripheral defocusing refers to the effects of the lens on the temporal or nasal retinal quadrants of the patient’s eye, respectively. 13. An anti-myopia eyeglass lens for a patient’s myopic eye, comprising a base lens having an optical axis and a central optical zone around this optical axis, corresponding to at least a normal pupil diameter and having a negative refractive power to correct refractive error in the central region of the eye and provide a good central vision, a therapeutic lens that is attached to said base lens has a non-refracting central zone corresponding to at least normal the diameter of the pupil, with the axis located mainly on one straight line with the said optical axis, and also has a ring-shaped peripheral zone surrounding the said non-refracting zone and characterized by an angle of incidence of 30 ° relative to the said axis, and this peripheral zone has a more positive refractive power than the force refraction of the central zone, so that the anti-myopia eyeglass lens has peripheral defocusing. 14. The anti-myopia eyeglass lens of claim 13, wherein said therapeutic lens is adhered to the surface of the base lens. 15. The anti-myopia eyeglass lens of claim 13, wherein the therapeutic lens has an annular shape and is made of a transparent material that does not extend into the refractory central zone. 16. A method for dispensing, prescribing or selecting an anti-myopia lens for a patient’s myopic eye, which measures the refractive error in the central region of the myopic eye, evaluates the patient’s predisposition to progressive myopia based on his medical history, selects the first lens from the kit, kit or stock of finished lenses having (i) the magnitude of the refractive correction in the central zone, which is in the best agreement with the measured refractive error, and (ii) the magnitude of the peripheral myopic defocus a test which is in the best agreement with the patient’s estimated predisposition to progressive myopia, fitting the first selected lens to the myopic eye to determine if the patient responds to the acceptability or unacceptability of peripheral blur associated with the mentioned myopic defocusing of the first selected lens, if the myopic defocus value is determined to be acceptable, dispensing or administering to the patient an anti-myopia lens having optical power in the central zone and peripheral defocusing For the first selected lens, if the myopic defocus value of the first selected lens is unacceptable, selecting another lens from a kit, kit or stock with the same refractive correction in the central zone as the first selected lens, but with a smaller peripheral myopic defocus and dispensing or administering to the patient an anti-myopia lens having optical correction power in the central zone and reduced peripheral myopic defocus of said next selected lens. 17. The method of claim 16, wherein said lens kit, kit or stock is a kit, kit or stock of prefabricated lenses for use in providing an anti-myopia lens for a myopia patient’s eye, in which each lens of the kit, kit or stock has a central the optical axis and the central optical zone surrounding and including this axis, the central optical zone has an optical refraction correction power in the range from low refraction to -6.0 D, each lens has a peripheral optical zone, zhayuschuyu said central zone, the peripheral zone is characterized by the angle of incidence of approximately 30 ° relative to the optical axis. 18. A method for dispensing, prescribing or selecting an anti-myopia lens for a patient’s myopic eye from a kit, kit or stock of pre-made lenses containing several lenses having the same refractive power in the central zone, but different levels of myopic peripheral defocusing in which to measure refractive error in the central region of the myopic eye, an assessment of the patient's predisposition to progressive myopia based on his medical history, vacation, prescription or selection of lenses from the mentioned th set, kit or stock, having (i) the magnitude of refractive power in the central zone, which provides correction of the measured refractive error and (ii) the magnitude of myopic peripheral defocus corresponding to assessed propensity for progressive myopia patient. 19. A method for dispensing, prescribing or selecting an anti-myopia lens for the myopic eye of a patient who wears glasses daily, in which the measurement of refractive error in the central region of the myopic eye is carried out, the patient is predisposed to progressive myopia based on his medical history, dispensing, prescribing or selecting a lens from said kit, kit or stock having (i) a magnitude of the refractive power in the central zone providing correction of the measured refractive error, and (ii) the magnitude of the myopic periphery iynoy defocus corresponding to the estimated patient predisposition to progressive myopia. 20. A method of manufacturing an anti-myopia spectacle lens for the patient’s myopic eye, which measures the refractive error in the central region of the eye, assesses the patient’s predisposition to progressive myopia based on his medical history, assigns and adjusts to the eye a standard spectacle lens with an optical axis and provides correction mentioned refractive error and good central vision, selection of an auxiliary lens with a non-refracting central zone corresponding to at least normal the diameter of the pupil, having a central axis and surrounded by a peripheral zone with positive optical power, corresponding to the patient's estimated predisposition to progressive myopia, coaxially bonding said auxiliary lens to a standard lens so that the central axis of the auxiliary lens is predominantly on a straight line with the said optical axis, the combination of standard and auxiliary lenses provides peripheral defocusing to slow the development of eye myopia but. 21. An ophthalmic device for slowing the development of myopia of the eye, containing a central spherical part with a given optical power, determined by the degree of myopia of the eye, a peripheral part with a given distribution of optical power, which provides relative refraction in the peripheral region of the eye, the said distribution of optical power in which determines peripheral defocusing wherein said peripheral defocusing is the difference between the optical powers of the central and peripheral spheres of the peripheral parts, and is a function of the optical power of the central spherical part. 22. The ophthalmic device according to item 21, in which the central spherical part with a given optical power includes a central spherical cylinder part with a given optical power, determined by the degree of myopia. 23. The ophthalmic device according to item 21, in which peripheral defocusing is determined by the average value of relative refraction in the peripheral region established for any population group. 24. The ophthalmic device according to item 21, which is part of a sequence of ophthalmic devices, including an ophthalmic device with average peripheral defocusing, an ophthalmic device with peripheral defocusing above average, and an ophthalmic device with peripheral defocusing below average, where the average peripheral defocusing is determined by the average value established for a specific population. 25. The ophthalmic device according to item 21, in which peripheral defocusing is approximately described by a linear first-order equation as a constant function of the optical power of the Central spherical part. 26. The ophthalmic device according to item 21, in which peripheral defocusing is a nonlinear function of the optical power of the Central spherical part. 27. The ophthalmic device according to claim 26, wherein the peripheral defocus non-linearly increases or decreases as a function of the optical power of the central spherical part. 28. The ophthalmic device according to item 21, in which peripheral defocusing up to 30 ° from the Central axis is approximately 0.25-4.00 D. 29. The ophthalmic device according to item 21, in which peripheral defocusing up to 40 ° from the Central axis is approximately 0.5-6.00 D. 30. A method of slowing the development of myopia of the eye, which consists in placing an ophthalmic device on the eye that contains a central spherical part with a given optical power, determined by the degree of myopia of the eye, a peripheral part with a given distribution of optical power, providing myopic defocusing and determining peripheral defocusing, where the mentioned peripheral defocusing represents the difference between the optical forces of the central and peripheral spherical parts, determined along the curve distribution of optical power in the peripheral part, and is a function of the optical power of the central spherical part. 31. The method according to clause 30, in which the ophthalmic device is part of a series of devices, including an ophthalmic device with average peripheral defocusing, an ophthalmic device with peripheral defocusing above average and an ophthalmic device with peripheral defocusing below average, where the said average peripheral defocusing is determined by, established for a specific group of the population. 32. The method according to item 30, in which peripheral defocusing is approximately described by a linear equation of the first order as a constant function of the optical power of the Central spherical part. 33. The method according to clause 30, in which peripheral defocusing is a nonlinear function of the optical power of the Central spherical part. 34. The method according to clause 33, in which the peripheral defocusing non-linearly increases or decreases as a function of the optical power of the Central spherical part. 35. The method according to item 30, in which the peripheral defocusing up to 30 ° from the Central axis is approximately 0.25-4.00 D. 36. The method according to item 30, in which peripheral defocusing up to 40 ° from the Central axis is approximately 0.5-6.00 D.

Images